Comparative Efficacy of Analgesic Gel Phonophoresis and Ultrasound in the Treatment of Temporomandibular Joint Disorders

Abstract

Background: Temporomandibular joint disorders (TMDs) are prevalent musculoskeletal problems impacting the orofacial area, frequently characterized by pain, limited jaw mobility, and audible joint sounds. Conservative management, encompassing therapeutic ultrasound and phonophoresis, has demonstrated efficacy in alleviating symptoms. Nevertheless, there exists a paucity of comparison data assessing the efficiency of analgesic gel phonophoresis in relation to conventional ultrasound therapy for the treatment of temporomandibular disorders (TMD).

Objective: To evaluate the clinical effectiveness of analgesic gel phonophoresis against therapeutic ultrasound in enhancing pain relief, functional mouth opening, and overall quality of life in individuals with temporomandibular disorders (TMD).

Methods: A prospective, randomized controlled trial was executed over a duration of 6 months at Krishna Nagar Institute of Medical Sciences, Nadia, involving 50 patients diagnosed with temporomandibular disorder (TMD). Patients were randomly assigned to two groups: Group A (n = 25): Administered phonophoresis utilizing an analgesic gel (diclofenac-based) in conjunction with ultrasound.  Group B (n = 25): Administered standard therapeutic ultrasonography devoid of gel. Each participant received therapy sessions thrice weekly for a duration of four weeks. Outcomes were evaluated before and after the intervention utilizing: Visual Analog Scale (VAS) for pain assessment
Interincisal distance (mouth opening in millimeters)  Jaw Functional Limitation Scale (JFLS)

Results: Both groups exhibited substantial enhancement from baseline across all outcome measures (p < 0.05). Group A (phonophoresis) exhibited a markedly superior reduction in pain scores (mean VAS reduction: 4.2 vs. 3.1), a more substantial increase in interincisal openness (7.8 mm vs. 5.3 mm), and a more favorable improvement in JFLS scores compared to Group B (p < 0.01). No negative effects were observed in either group.

Conclusion: Analgesic gel phonophoresis surpasses conventional ultrasonography in alleviating pain and enhancing mandibular function in individuals with temporomandibular joint problems. The findings endorse the incorporation of phonophoresis into standard conservative physiotherapeutic procedures for the management of temporomandibular disorders (TMD).